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Ayana Suzuki Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Japan

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Mitsuyoshi Hirokawa Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Japan

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Izumi Otsuka Secretary Section, Kuma Hospital, Kobe, Japan

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Akihiro Miya Department of Surgery, Kuma Hospital, Kobe, Japan

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Akira Miyauchi Department of Surgery, Kuma Hospital, Kobe, Japan

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Takashi Akamizu Department of Internal Medicine, Kuma Hospital, Kobe, Japan

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length of the whole tumor and the solid area in three directions on ultrasound images using the formula ( Fig. 1 ). Whole tumor diameter (WTD; Fig. 1D ) and solid area diameter (SAD; Fig. 1A ) were defined as the maximum diameter in the three

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Keiko Ohkuwa Department of Surgery, Ito Hospital, Tokyo, Japan

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Kiminori Sugino Department of Surgery, Ito Hospital, Tokyo, Japan

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Mitsuji Nagahama Department of Surgery, Ito Hospital, Tokyo, Japan

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Wataru Kitagawa Department of Surgery, Ito Hospital, Tokyo, Japan

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Kenichi Matsuzu Department of Surgery, Ito Hospital, Tokyo, Japan

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Akifumi Suzuki Department of Surgery, Ito Hospital, Tokyo, Japan

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Chisato Tomoda Department of Surgery, Ito Hospital, Tokyo, Japan

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Kiyomi Hames Department of Surgery, Ito Hospital, Tokyo, Japan

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Junko Akaishi Department of Surgery, Ito Hospital, Tokyo, Japan

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Chie Masaki Department of Surgery, Ito Hospital, Tokyo, Japan

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Koichi Ito Department of Surgery, Ito Hospital, Tokyo, Japan

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follows: (i) no accumulation of RAI, (ii) tumor growth even with little accumulation of RAI, and (iii) tumor growth after RAI therapy (≥ 600 mCi). Based on the American Thyroid Association Guidelines, 18F-fluorodeoxyglucose PET/CT (18FDG-PET/CT), whole

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Reem Al Argan Endocrine Section, Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia

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Abdulaziz Ramadhan Division of Endocrinology and Metabolism, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada

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Ramanakumar V Agnihotram Statistician, Research Institute-McGill University Health Center, Montreal, Quebec, Canada

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Jeffrey Chankowsky Department of Diagnostic Radiology, McGill University Health Center, Montreal, Quebec, Canada

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Juan Rivera Division of Endocrinology and Metabolism, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada

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). In regards to tumor size, various tumor diameter cut-off has been proposed as predictors of specific pituitary hormone deficiencies ( 16 ). The current report presents our findings in a group of unselected patients with NFPA. We aim to establish

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Xinlei Chen Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Liru Hu Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Caojie Liu Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Guangcheng Ni Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Yuwei Zhang Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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was 5.7 years, with a median of 1.0 years (range: 0.05–30 years). All patients’ diagnoses were confirmed through postoperative histological examination by experienced pathologists. Average tumor diameter was 4.9 ± 2.3 cm and 370 of the tumors (70

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M Ingenwerth Institute of Pathology, University Hospital of Essen, University of Duisburg–Essen, Essen, Germany

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T Brandenburg Division of Laboratory Research, Department of Endocrinology, Diabetes and Metabolism and Clinical Chemistry, University Hospital Essen, University of Duisburg-Essen, Germany

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D Führer-Sakel Division of Laboratory Research, Department of Endocrinology, Diabetes and Metabolism and Clinical Chemistry, University Hospital Essen, University of Duisburg-Essen, Germany

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M Goetz Institute of Pathology, University Hospital of Essen, University of Duisburg–Essen, Essen, Germany

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F Weber Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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H Dralle Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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H-U Schildhaus Institute of Pathology, University Hospital of Essen, University of Duisburg–Essen, Essen, Germany

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K W Schmid Institute of Pathology, University Hospital of Essen, University of Duisburg–Essen, Essen, Germany

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S Theurer Institute of Pathology, University Hospital of Essen, University of Duisburg–Essen, Essen, Germany

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slide and corresponding core biopsies of 2 mm diameter were taken in triplicates with a TMA Grand Master System (3DHistech, Hungary) according to the manufacturer’s protocol. 10 cases were left out for whole slide stains to assess distribution of

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Logan Mills Institute of Liver Studies, King’s College Hospital, London, UK

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Panagiotis Drymousis Department of Surgery and Cancer, Imperial College, London, UK

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Yogesh Vashist Department of General, Visceral and Thoracic Surgery, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany

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Christoph Burdelski Department of General, Visceral and Thoracic Surgery, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany

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Andreas Prachalias Department of Surgery, King’s College Hospital, London, UK

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Parthi Srinivasan Department of Surgery, King’s College Hospital, London, UK

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Krishna Menon Department of Surgery, King’s College Hospital, London, UK

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Corina Cotoi Department of Histopathology, King’s College Hospital, London, UK

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Saboor Khan Department of Surgery, University Hospitals Coventry and Warwickshire, Coventry, UK

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Judith Cave Department of Oncology, University Hospital, Southampton, UK

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Thomas Armstrong Department of Surgery, University Hospital, Southampton, UK

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Martin O Weickert Department of Endocrinology, University Hospitals Coventry and Warwickshire, Coventry, UK

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Jakob Izbicki Department of General, Visceral and Thoracic Surgery, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany

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Joerg Schrader Departments of Gastroenterology and Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Andreja Frilling Department of Surgery and Cancer, Imperial College, London, UK

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John K Ramage Institute of Liver Studies, King’s College Hospital, London, UK

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Raj Srirajaskanthan Institute of Liver Studies, King’s College Hospital, London, UK

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Scientific Ethics Committee (REGO-2015-1675). Data collection Patient notes were reviewed for relevant variables, and data were collated between centres using a standardised Microsoft Access v16 database. Tumour diameter, morphology and

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Stefan M Constantinescu Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Brussels, Belgium

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Thierry Duprez Department of Radiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium

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Edward Fomekong Department of Neurosurgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium

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Christian Raftopoulos Department of Neurosurgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium

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Orsalia Alexopoulou Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Brussels, Belgium

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Dominique Maiter Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Brussels, Belgium

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defects in eight out of the 36 patients with chiasmal contact of the tumor. Of note, only one of the eight patients had subjective perception of the defect. Twenty-four (37%) patients complained of headache. The mean maximal tumor diameter was 20.0 ± 7

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Jing Zhang Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
Second Clinical School, Lanzhou University, Lanzhou, China

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Zhiyong Zhao Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
Second Clinical School, Lanzhou University, Lanzhou, China

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Li Dong Department of Pathology, Lanzhou University Second Hospital, Lanzhou, China

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Tao Han Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
Second Clinical School, Lanzhou University, Lanzhou, China

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Guojin Zhang Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
Second Clinical School, Lanzhou University, Lanzhou, China

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Yuntai Cao Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
Second Clinical School, Lanzhou University, Lanzhou, China

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Junlin Zhou Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
Second Clinical School, Lanzhou University, Lanzhou, China

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adenomas account for 14–54% of pituitary adenomas and lack biochemical evidence of hormone secretion ( 4 ). Tumors with a diameter of greater than or equal to 10 mm are considered macroadenomas ( 2 ). In contrast, sellar meningiomas arise from adjacent

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Shan Wu College of Chemical and Pharmaceutical Engineering, Hebei University of Science and Technology, Shijiazhuang, People’s Republic of China
Research Center for Translational Medicine, Cancer Stem Cell Institute, East Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China

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Jianjun Zhou Research Center for Translational Medicine, Cancer Stem Cell Institute, East Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China

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Jing Guo Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, People’s Republic of China

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Zhan Hua Department of General Surgery, China-Japan Friendship Hospital, Beijing, People’s Republic of China

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Jianchen Li College of Chemical and Pharmaceutical Engineering, Hebei University of Science and Technology, Shijiazhuang, People’s Republic of China

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Zai Wang Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, People’s Republic of China

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of the back. Tumor growth was evaluated every other day by measuring of the tumor diameter (mm) along the largest ( a ) and perpendicular ( b ) axes, from which the tumor volume ( V ; mm 3 ) was calculated according to the formula: V  = 0.5 ×  a

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Solène Castellnou Service d’Endocrinologie, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
Université Lyon 1, Villeurbanne, France

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Alexandre Vasiljevic Université Lyon 1, Villeurbanne, France
Centre de Biologie et Pathologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France

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Véronique Lapras Service de Radiologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France

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Véronique Raverot Laboratoire d’Hormonologie, Centre de Biologie et Pathologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France

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Eudeline Alix Département de Cytogénétique, Centre de Biologie et Pathologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France

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Françoise Borson-Chazot Service d’Endocrinologie, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
Université Lyon 1, Villeurbanne, France

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Emmanuel Jouanneau Université Lyon 1, Villeurbanne, France
INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
Service de Neurochirurgie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France

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Gérald Raverot Service d’Endocrinologie, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
Université Lyon 1, Villeurbanne, France
INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France

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Hélène Lasolle Service d’Endocrinologie, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
Université Lyon 1, Villeurbanne, France
INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France

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clinical or biochemical signs of Cushing’s disease were present prior to surgery. Preoperative MRI were reviewed by a pituitary specialist radiologist (V L), and the tumor size, defined as the largest diameter observed on MRI, and cavernous sinus invasion

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